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MC-15-280Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227897 Permit Number: MC -2-15-280 Scheduled Inspection Date: February 18, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Owner: LEGER, JUSELAINE Job Address: 47 NW 101 Street Miami Shores, FL 33150 - Project: <NONE> Contractor: TYCOON FLOW CONTROL Building Department Comments inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1131010180200 Phone: (305)828-6655 REPLACEMENT OF A/C 3 TON UNIT�---� -- INSPECTOR COMMENTS False q-2--1 1 k E51L5 February 18, 2015 For Inspections please call: (305)7624949 Page 30 of 52 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid February 18, 2015 For Inspections please call: (305)7624949 Page 30 of 52 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING 0 MECHANICAL ❑PUBLICWORKS JOB ADDRESS: 47 NW 101 Street FEB09 2015 FBC 2010 Master Permit NO.// %E Z6 ----2&Q Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City Miami Shores County Miami Dade Zip: Folio/Parcel#:11-3101-018-0200 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: - BFE: FFE: OWNER: Name (Fee Simple Titleholder): Juselaine Legar Phone#:305-756-5642 Address:47 NW 101 Street City: Miami Shores State: Fla Zip: 33130 Tenant/Lessee Name: Phone#:305-756-5642 Email: CONTRACTOR: Company Name: Tycoon Flow Control Corp Phone#: 305-828-6655 2500 West 78 Street Bay 9 City. Hialeahstate Fla Zip: 33012 Qualifier Name: Felipe D Soler Phone#: 305-218-0788Cc State Certification or Registration #: CAC1813708 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: _ Address: City: State: Value of Work for this Permit: $z 1 L • Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace Description of Work: Replacement of A/C Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ -2612, Z --CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews,. (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ • 140 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 14 Signature Signatu C AER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this f day of� ZO by day of , 2015 , by r,?1 , who is personally known to ¢P� <> % . J,-lC� who is personally known to me or who has produce% . A (eo-Qo—(I " SVP r a as produce as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: Print: /���rri"Ailli"R(A.R Seal: Commisslor# FF X2157 Expires January 9,2018 BwAad Thu TMY Fain i sm'1w"19 NOTARY PUBLIC: �NMN��BNeN�NeN�N�N<N+�RNaRNe*B�kkN�4*N�4Nak4Nak NaR��k+b/ b�kNaM ■`!� N�N�Ns#+RNab*N'&N�N<N�*Nide,kN�N�MN�N�Ne$�k4��kN+4N��kBffi APPROVED BY 0 Plans Examiner IJ Structural Review (Revised02/24/2014) �W Zoning Clerk Av®CERTIFICATE OF LIABILITY INSURANCE DAO Osi15 PRODUCER South Pacific Professional Ins. 500 K W. 49th Street THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hialeah, FL 33012 ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL INSURERS AFFORDING COVERAGE NAIC # Phone (305)825-3535 Fax (305)825-5894 INSURED TYCOON FLOW CONTROL CORP INSURER A: GRANADA COMMERCIAL INS CO 13683 GLO185FL00052827 i 2500 W 78 St Bay # 9 Hialeah, FL 33016 PH(305)218-0788 INSURER B: I INSURER C: INSURER 0: _ INSURER E: ASCENDANT UNDERWRITERS, LLC 1 13683 COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L� 1 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YYYY POLICY EXPIRATION DATE D LIMITS A ® GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑❑ CLAIMS MADE ® OCCUR ❑ ❑ GERL AGGREGATE LIMIT APPLIES PER: W POLICY ❑ PROJECT ❑ LOC GLO185FL00052827 i 09/23/2014 09/232015 EACH OCCURRENCE 1,000,000 DATMOE NTED PREMISES EaEacauraftW 100,000 MED EXP. (Anyone peen) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 j ❑ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS ❑ -- ( I COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) ^_ PROPERTY DAMAGE (Per accident ❑ GARAGE UA131UTY ❑ ANY AUTO AUTO ONLY - EA ACCIDENT i OTHER THAN EA ACC AUTO ONLY. AGG J� ❑ EXCESS / UMBRELLA LIABILITY [3OCCUR E3CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ S I i j EACH OCCURRENCE i AGGREGATE E WORKERS COMPENSATION AND EMPLOYERV LL481UTY Y/N ANY PROPRIETOR / PARTNER I EXECUTIVE OFFICER I MEMBER EXCLUDED? (Mandatory in NH) It� describe under SPEG�IAL PROVISIONS below WC -60803-5 j 09232014 I 09232015 ❑ WC�S7ATU- ❑ OTFI- T L�nit res F E.L. EACH ACCIDENT _ 500,000 -- E.L. DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT 500,000 OTHER i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS AIR CONDITIONING-CAC1813706 t CERTIFICATE HOLDER ACORD 25 (2009101) OF ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD POLICIES BE CANCELLED BEFORE THE EXPIRATI ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 WCRIBED TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2 AVENUE THE LEFTO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY K, ITS AGENTS OR REPRESENTATIVES. MIAMI SHORES, FL 33138 AUTHORIZED NTarIVE FAX 305-756-8972 ACORD 25 (2009101) OF ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 2,5,5� LICENSE NUMBER ml Office Location: ORLANDO Proposal Date 01/31/2015 lJob Number 18139034 Sears Home Improvement Products, Inc. Customer Name�'� P.O. Box 522290 JUSLAINE LEGER Home Improvement Products 1024 Florida Central Parkway Longwood, FL 32750-7579 Customer's Home Phone Customer's Work Phone (305) 756-5642 Phone 800 469-4663 Street Address ESTIMATE AND PROPOSAL Contractor License/Registration Number 47 NW 101ST ST FL (CGC012538, CMC1249510) Heating &Cooling city State zip Coda MIAMI SHORES FL 33150 Is installation within city limits? Ns/No): YES Installation Address County MIAMI-DADE Billing Address (if different from above) city State Mp Code Project Consultant Name & License No. (d applicable) I EMMY HOFMANN H15521661320 Desai ion of the Project and Description of the Significant Materials to be Used and Equipment to be installed SYSTEM INFORMATION: Equipment Brand: KENMORE (Split System/Package/Dual Fuel/Straight Cool eat Pump/Fumace): D R-41 OA SEER: Cooling BTU: KW: EQUIPMENT SPECIFICATIONS: FURNACE FUEL: (Gas/OH/LP Gas/Electric): Existing New MODEL # OF NEW COMPONENT AFUE (up to): Heating BTU: ELECTRICAL: ❑ ® FURNACE/FAN COIL FvM4x2400BL ❑ ® CONDENSER UNIT NXA636GKA ® CONNECT TO EXISTING ELECTRICAL ❑ ❑ EVAPORATOR COIL ❑ INSTALL NEW AMP MAIN PANEL ❑ ❑ PACKAGE UNIT ❑ NEW DISCONNECT ❑ FURNACE ❑ CONDENSER ❑ ® THERMOSTAT 1F95-1291SE ❑ NEW GFI OUTLET ❑ ATTIC LIGHT & RECEPTACLE ❑ ❑ HUMIDIFIER Other. DUCT WORK: ❑ ❑ AIR CLEANER ❑ ❑ UV LIGHT ® RE -USE EXISTING DUCT SYSTEM ❑ ❑ EVAP COOLER ❑ INSTALL NEW DUCT SYSTEM WITH # NEW RUNS MISCELLANEOUS: Rl REBUILD PLENUM (Supply/Retum): ❑ ❑ LINE SET ❑ PAD " x " ❑ NEW TRUNK LINE(S) (Supply/Retum): ❑ ❑ DRAIN LINE ❑ CONDENSATE PUMP ❑ NEW RETURN GRILL(S) X X ❑ ❑ AUXILIARY DRAIN PAN ❑ Other ❑ EXISTING RETURN GRILL SIZE INSULATION: ❑ REPLACE REGISTER(S)# ❑ ❑ (Batt/Blown): R -Value ❑ DUCT CLEANING Other: FLUE VENTING AND/OR CHIMNEY: ❑ Use existing vent or chimney ❑ Install new chimney liner Size: ❑ PVC Vent Pipe for High -Efficiency Furnace ❑ Horizontal ❑ Vertical ❑ Type=B Vent Pipe ❑ Stainless Steel Vent Pipe ❑ 1 Pipe Installation ❑ 2 Pipe Installation ❑ Combustion Air ❑ Existing ❑ Modify SPECIAL INSTRUCTIONS: CALL AHEAD All of the above check boxes and "Special Instructions" section have been reviewed and Customer(s) initials explained to me. SHl-t3_ (Dlg.) Rev 02/10/12 Page 1 of 3 1111111111111111 Job Number. 18139034 APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 02/05/2015 (Approximate Start Date) It will be substantially completed by approximately 02/06/2015 (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears') or at any other time by mutual written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. ASBESTOS ABATEMENT. This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs°) that would be disturbed in the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary asbestos abatement within thirty (30) days, Sears may cancel this contract upon Customer(s) initials written notice to Customer. PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pro -existing conditions of any ductwork, piping, electrical supplies or equipment not being replaced at this time. If additional work is required, it will be the Customer's responsibility. Any additional charges will be quoted and approved prior to the start of any additional work. Customer(s) initials -5 , THE CONTRACT PRICE INCLUDES: Edo A copy of the terms and conditions of the Master Protection Agreement or Re- -Year Master Protection Agreement ❑ $ pair Protection Agreement (as applicable) have been provided to Customer. -Year Repair Protection Agreement ❑ $ Customer(s) initials -5 . L... 11 The TOTAL PRICE including all labor, material, taxes and any applicable discount is $ 6,098.12. Contract Price $6,098.12 State Sales Tax ( 0.00 %) $ 0.00 Local Sales Tax ( o. oo %) $ o. oo FPL REBATE $306.00 Customer Payinent is due prior to Sears' placement of Special Order for products. Total Amount Due $ 5, 792.12 The form and method by which the Customer(s) will pay is described in a separate Cash/Credit Customers) initials Card Payment Addendum made a part of and incorporated into this contract by reference. NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD UUMNE55 UAT (rir i H BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER) AFTER THE DATE OF THIS TRANSAC- TION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ADDITIONAL PROVISIONS Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law, this offer will be withdrawn and any payments you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation . I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT furnished or arranged by Sears. Sears' installation contractor(s) will obtain all building permits required by local law. For homes located in historic or landmark zoning districts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorizatiion. I authorize Sears to: (1) arrange for a contractor (licensed where required by law) to make the installation of materials; (2) issue a work order for this installation to a contractor; (3) inspect the installation; and (4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather, fire, strikes, war, government regulations or any causes beyond Sears' control. Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been included in writing in this contract. Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work described in this contract Electrical S Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warraft Information. Appropriate product warranty documents will be given to me by Sears. Sears' Warranty on Installation is: SEARS' LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s) used (which warranty becomes effective the date the merchandise is installed), if the workmanship (or application) of any Sears' arranged installation proves faulty within one year after the completion of installation, then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made, then, at Sears' sole discretion, Sears may elect to provide replacement or refund. Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1.800.222.5030, Option 4. This warranty gives you specific legal rights, and you may also have other rights that vary from State to State. SH1+L (Dig.) Rev 02/10/12 Page 2 of 3 Job Number. 18139034 NOTICE TO BUYER 1. 'DO NOT SIGN THEAGREEMENT IFANYOF THE SPACES INTENDED FORTHEAGREED TERMS TO THE EXTENT OFTHEAVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. THIS HOME IMPROVEMENT CONTRACT MAY CONTAIN A MORTGAGE OR OTHERWISE CREATE A LIEN ON YOUR PROPERTY THAT COULD BE FORECLOSED ON IF YOU DO NOT PAY. BE SURE YOU UNDERSTAND ALL PROVISIONS OF THIS CONTRACT BEFORE YOU SIGN. 4. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME, AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 5. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY [FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER] AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING "I HEREBY RESCIND" AND ADDING YOUR NAME AND ADDRESS. A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. PAYMENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT, WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CONTACT THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS: CONSTRUCTION INDUSTRIES RECOVERY FUND, 1940 NORTH MONROE STREET, TALLAHASSEE, FL 32399; TELEPHONE: (650) 921.6593. ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT' THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S' CONSTRUCTION LIEN LAW IS COMPLEX, AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. 90x-- /020Z 01/31/2015 ustome s signature —Date — 01/31/2015 Customer's signature Date Accepted by Sears Home Improvement Products, Inc. ("Sears") on 01/31/2015 by: aT Date Manaoment Representative SHl-FL (Dig.) Rev 02/10/12 Page 3 of 3 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done):47 NW 101 Street City: Miami Shores Village County: Miami Dade Zip Code: 33150 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO ■❑ ARHI Sheet Attached: YES ❑■ NO ❑ Contract Attached: YESFE] 1. Minimum Circuit Ampacity (Wire Size): 6 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 150 3. Voltage of Circuit (208/240/480): 208 4. Size Disconnecting Means: 40 Contractor's Company Name: Tycoon Flow Control Corp Phone: 305-828-6655 State Certificate or Registr tion Ido. CAC1813706 Certificate of Competency No. Signature Y Date: 1 /9/15 (Qualfftees signature) (Revised02/24/2014) UNIT BEING REPLACED DATA NEW UNIT Goodman MANUFACTURER Kenmore CKH30-1B AHU or PKG. UNIT MODEL# FVM4X3600 A32 -08C COND. UNIT MODEL# NXA636GKA 7kw KW HEAT 7kw 3 tons NOM TONS 3 tons AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER 16 Seer YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 6 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 150 3. Voltage of Circuit (208/240/480): 208 4. Size Disconnecting Means: 40 Contractor's Company Name: Tycoon Flow Control Corp Phone: 305-828-6655 State Certificate or Registr tion Ido. CAC1813706 Certificate of Competency No. Signature Y Date: 1 /9/15 (Qualfftees signature) (Revised02/24/2014) This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17, 2009 and Dec 31, 2013. �� 11101 �� ��t q.fir, .<� o . 0�\ 4 AHRI Certified Reference Number: 7025224 Date: 2/6/2015 Product: Split System: Air -Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number: NXA636GIW Indoor Unit Model Number: FVM4X36***L* Manufacturer: KENMORE Trade/Brand name: KENMORE Series name: 16 SEER N SERIES R41 OA AC Manufacturer responsible for the rating of this system combination Is KENMORE Rated as follows In accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 33600 EER Rating (Cooling): 13.00 SEER Rating (Cooling} 16.00 IEER Rating (Cooling): ` Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerats. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the produet(A or the unautitorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.uhridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; N entered Into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AV�S , personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link %w make. lift Mier' and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which Is listed above, and the Certificate No., which is listed at bottom right _ 1306771381812519! 02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: